Tooth Calendar Blog
Baby's First Tooth: When It Comes In and How to Start Brushing
The first baby tooth usually comes in around 6 months, bottom front first. The normal range, order of teeth, how to start brushing, and when to see a dentist.
At a glance
- Usually bottom front teeth first. Anywhere from 4–12 months is normal
- A rice-grain smear of fluoride toothpaste, twice a day
- First dental visit by the first birthday
When you spot a tiny white edge peeking through your baby's gum, it's exciting, and it brings lots of questions. When is it normal for teeth to come in? Do you need to brush already? How do you soothe a fussy baby? Here's what parents should know when the first baby tooth arrives.
When and where the first tooth comes in
The first baby tooth usually comes in around 6 months, starting with the bottom front teeth. But babies vary a lot. Some get a tooth at 4 months, and others not until almost 12 months. Anywhere in this range is normal. A tooth coming in a little late doesn't mean the teeth are weak or that your baby is growing slowly.
Usually the two bottom front teeth come first, and the top front teeth follow within a few months. After that come the teeth beside them, the first molars, the canines, and the second molars, slowly, until all 20 baby teeth are in place around age 2 to 3. If the order is a little different, that's usually no problem.
Around the time a tooth comes in, your baby may drool a lot, chew on hands and objects, or sleep poorly. That's because the gums feel itchy and swollen. This usually lasts a few days at most and then passes.
There's one key thing to remember. As soon as even one tooth comes in, it's at risk for cavities from then on. Baby teeth have a thinner outer layer (enamel) than adult teeth, so cavities move fast. That's why brushing doesn't start "once all the teeth are in." It starts "the day the first tooth appears."
Start brushing the day it shows
At first, brushing at the same times every day matters more than how long you brush. Here's how to start.
- Get a baby toothbrush with a small head and soft bristles. When there are only one or two teeth, a finger brush or clean gauze works too.
- Put a rice-grain smear of fluoride toothpaste on the bristles, just a thin layer.
- Lay your baby on your lap with the head toward your tummy. You'll see inside the mouth better, and the head stays steady.
- Gently brush in small circles where the teeth meet the gums. Brush both the front and back of each tooth.
- Brush twice a day: once in the morning and once before bed.
The most important brushing of the day is before bed. Saliva drops during sleep, so the mouth isn't rinsed as well. If you feed at night, clean the teeth with gauze or the brush after night feeds too.
It's fine if your baby can't spit yet. A rice-grain smear is a tiny amount chosen for babies who can't spit yet, so swallowing a little while brushing usually isn't a concern. In fact, if you brush without toothpaste to avoid fluoride, you miss out on fluoride's cavity protection.
It's normal for your baby to cry or turn away at first. Singing or following the same steps every day helps your baby get used to it. If you only manage a few seconds some days, that's okay. Just try again tomorrow.
When your baby is fussy from teething, offer a clean teething ring chilled in the fridge, or wash your hands and gently press on the gums with your finger.
United States guidance
US guidance
The American Dental Association recommends brushing twice a day with a smear (rice-grain amount) of fluoride toothpaste as soon as the first tooth appears. Standard US fluoride toothpaste contains about 1000-1100 ppm fluoride; fluoride-free 'training' toothpaste is not recommended for children under 3.
Frequently asked questions
My baby is almost one and has no teeth yet. Is that okay?
Up to 12 months is within the normal range. But if there are still no teeth at all after the first birthday, have a dentist take a look.
Can teething cause a fever?
Fussiness and drooling are common when teeth come in. But if there's a high fever or ongoing diarrhea, don't assume it's teething. See your pediatrician.
There's only one tooth. Do I really need toothpaste?
Yes. Even one tooth can get a cavity, so use a rice-grain smear of fluoride toothpaste from the very first tooth. It's such a small amount that swallowing a little while brushing usually isn't a concern.
When should the first dental visit be?
Within 6 months of the first tooth, and no later than the first birthday. It's not about treatment. It's a visit to check the teeth and get tips on brushing and daily habits.
When to see a dentist
- No teeth have come in by the first birthday
- You see a white band or a chalky, dull patch on a tooth
- A brown or black spot appears on a tooth
- The gums stay swollen or keep bleeding for more than a few days
- It's been 6 months since the first tooth and you haven't been to the dentist yet
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Tooth Calendar follows dental care from pregnancy to eighteen in 78 chapters. Explore the reasons behind feeding, brushing, baby-tooth decay, sedation, and injury decisions—including what can be watched and when to seek help. Age-based contents and a topic index help you find the concern you have today.
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Sources
- AAPD · Fluoride Therapy (2023)
- ADA · Eruption Charts (2024)
- FDA · Safely Soothing Teething Pain and Sensitivity in Infants and Toddlers (2018)
The information in this article is for general educational purposes and does not replace professional dental care. Talk to a dentist about your child's condition.